The Skeptics' Guide to EM

MARCH 11, 2023

A fire company is on scene providing high-quality cardiopulmonary resuscitation (CPR) and has defibrillated twice with an automated external defibrillator (AED). Background: Airway management strategies for out of hospital cardiac arrest (OHCA) have been hotly debated since the dawn of CPR. Reference: Smida et al.

Airway Management 52

Airway Management Basic Life Support CPR Resuscitation 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

There is significant evidence in adults and developing in the paediatric population that TXA results in better outcomes if given early in patients with mild to moderate traumatic brain injury (TBI) and does not cause harm. Don’t Forget the Bubbles, 2018. TXA in head injuries. Don’t Forget the Bubbles, 2023. Crisis Medicine.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

Don't Forget the Bubbles

JUNE 17, 2024

High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. A third RCT demonstrated that even brief low-level incivility could increase the risk of major error during CPR by up to 66%. John Wiley & Sons, 2018 Edward KL, Ousey K, Warelow P, Lui S. Australian Health Review.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

RebelEM

NOVEMBER 20, 2023

Outcome: Primary Outcome: All-cause mortality at 90 days. The primary outcome focused on patient-centered outcomes. The outcomes were predominantly binary and objective, reducing the potential for subjective interpretation and bias. 97% of patients sustained blunt trauma. 97% of patients sustained blunt trauma.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

The Skeptics' Guide to EM

AUGUST 14, 2021

They performed high-quality CPR and shocked the patient twice before giving amiodarone via intraosseous (IO). This has included the classic paper from Legend of EM Dr. Ian Stiell on BLS vs. ACLS ( SGEM#64 ), the use of mechanical CPR ( SGEM#136 ), and pre-hospital hypothermia ( SGEM#183 ).

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

Don't Forget the Bubbles

JULY 26, 2023

Low risk BRUE: Age >60 days Gestational age >32/40 Post conceptual age >45 weeks First episode No CPR given (by a trained medical provider) No concerning history or examination findings (eg FHx sudden cardiac death) Where the above features are present then investigation and hospital stay can be limited.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Don't Forget the Bubbles

OCTOBER 7, 2024

Prolonged CPR should be considered as outcomes are generally good, even if asystole is the presenting rhythm. The high voltage can cause direct thermal injuries, as well as mechanical injuries from falls or secondary trauma. In most paediatric cardiac arrests, the primary cause is respiratory – not so in cases of electrocution.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

Intensive Blog

MARCH 13, 2024

However, as practice has been refined and populations of patients who may benefit have been identified 5 , the use of extracorporeal CPR (ECPR) has been rapidly growing. The Steps of CPR reported in the Journal of Iowa Medical Society in 1964 by Peter Safar. Image source: File:Steps of CPR-1964.jpg jpg – Wikimedia Commons.

CPR 130

CPR Resuscitation Hospitals Outcomes 130

Don't Forget the Bubbles

DECEMBER 5, 2023

Roughly 30% of patients with ulcerative colitis are diagnosed as children or young adults, and this early diagnosis is associated with poorer long-term outcomes. The primary outcome measure was the time patients collected their repeat prescriptions, i.e. their adherence. PMID: 37666511; PMCID: PMC10498382. What’s it about?

Resuscitation 111

Resuscitation Outcomes CPR Emergency Department 111

RebelEM

DECEMBER 19, 2022

In fact, 4000 paramedics in total were not only trained in the study protocol but also given a rigorous evaluation of their ability to perform CPR. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. The prehospital providers in this study had an extensive amount of training.

EMS 52

EMS CPR Shock Resuscitation 52

Taming the SRU

JUNE 28, 2024

4) This higher likelihood of attaining return of spontaneous circulation (ROSC) is contingent upon high quality CPR and early defibrillation. In 2018, Cheskes et al in Canada decided to examine these therapies and compare their outcomes. ventricular tachycardia [v fib] and ventricular tachycardia [v tach]without a pulse).(1,2,3)

Shock 75

Shock Hospitals CPR Outcomes 75

Dr. Smith's ECG Blog

MARCH 8, 2025

Angiography was technically challenging as the patient was receiving CPR, but the cardiologist suspected acute stent thrombosis and initiated cangrelor, although no repeat angiography was able to be obtained. Was her outcome to be expected for ostial RCA OMI? She was defibrillated perhaps 25 times. We will never know for certain.

EKG/ECG 77

EKG/ECG CPR Resuscitation Wellness 77